Medical historian Dr Christine Alvin looks at the impact of the 1918 Spanish flu epidemic on life in Bradford.

AT the beginning of 1918 people were struggling through the miseries of their fourth winter in a world at war. The populations of many countries were short of food, some were starving. Millions of men had died in battle, in conditions unimaginable when they signed up to fight.

But worse was to come, in the words of the UK’s Chief Medical Officer, who described it afterwards as “one of the great historic scourges of our time, a pestilence which affected millions of men and women and destroyed more lives in a few months than did the European war in five years, carrying off upwards of 150,000 persons in England and Wales alone.”

Known as Spanish Flu, this deceptively mild illness erupted early in the summer of 1918. It mutated into a second wave in the autumn, then resurfaced for a third less virulent wave early 1919.

Bradford, like the rest of Britain, was unprepared. The early 20th century saw the start of an improvement in the health and environment of the city’s working people. But when the influenza arrived it infected victims regardless of whether they lived in a slum or healthier suburbs.

There’s still debate about the origin of the virus, but research suggests it came from China, and may have arrived in vast war camps at Etaples in northern France where there were millions of troop movements, and where many of the 135,000 Chinese Labour Corps workers began to arrive from 1916, some thought to have brought a form of flu that was raging in China.

Toward the end of November 1918, at the peak of the second wave, Bradford’s newspapers reported that the flu was ‘swine fever, caused by bad bacon’, whilst others maintained the Germans had deliberately unleashed the germs. It arrived in Bradford, in June 1918 maybe from injured soldiers transferred to local hospitals, or returning home.

On June 25, 1918 the Yorkshire Observer announced outbreaks in several parts of Bradford: “It spreads with extraordinary rapidity”...”the best advice is to avoid crowds and get plenty of fresh air”. Remedies were put forward. A Wharfedale doctor swore by a 48-hour diet of cold water. Quinine was widely taken, as a preventative and cure. A deceptive advert for a concoction called ‘Formamint’ (formaldehyde and lactose) was worded as if it was an ‘official’ medicine but was in fact made by a company notorious for selling useless remedies.

By July the flu was widespread. In Bradford it was affecting schools, not so seriously that it was thought necessary to close them. The chief sufferers were reportedly workers under 30, mainly women who’d replaced men fighting in the war. Some factories closed functions. One factory owner “adopted a determined method of fighting the malady, twice daily all workpeople have the opportunity of a free dose of the efficacious tincture of quinine... the workpeople greatly appreciate this thoughtful action”.

Initially the flu was mild, lasting 24 hours. There was little anyone could do other than follow the advice of doctors - fresh air, isolation and avoiding crowds. But deaths began to occur and there were fears of a recurrence in a more dangerous form. An inquest report hinted at the effect on families in Bradford: a 14-year-old son of a blacksmith’s striker “went to his work on Wednesday morning, but subsequently returned and complained of illness. On Thursday he suffered continued thirst and the following day began rambling. The same evening he died suddenly. No doctor had been called.”

It wasn’t easy to find a doctor. Bradford’s medical professionals were already under great strain. Many were serving abroad or treating invalided soldiers at the War Hospital, as St Luke’s was designated. Local doctors were overwhelmed, with no effective treatments and no antibiotics for bacterial pneumonia; a devastating role in the next wave. Bradford’s Medical Officer of Health reported on”the grave shortage of medical men and nurses”.

During this first, mainly mild, epidemic, Bradford newspapers ran warnings from doctors about the possibility of it returning in a more deadly form. “One such visitation in the past killed a number of old people, in another the patients suffered from nervous prostration, resulting, in some cases, in insanity”. Most warnings tended to be salutary though; one newspaper reported that “things are never so bad that they might not be worse”.

Whilst Leeds reported 101 flu deaths in the last week of October, Bradford had only 11. But suddenly symptoms became more severe. The death toll the following week was 35. The worst symptom was ‘heliotrope cyanosis’, when the lungs were starved of oxygen and the patient would turn purple, black or blue. Doctors struggled to understand the cause of this terrible ‘purple death’. Aspirin was prescribed, which may have done more harm than good, as did other ‘remedies’ such as arsenical preparations, digitalis, strychnine, even blood-letting. Quack remedies were offered in newspaper ads. Disinfectants were recommended, to be applied internally and externally. Permanganate of potash, known commercially as Condy’s Fluid, was recommended as a gargle, and for washing out the nostrils. The home could be cleaned with ‘Pinkobolic Soap’ or ‘Gossages Purified Carbolic Soap’, which claimed to ‘effectively combat disease’

On November 5, Bradford’s MoH advised that anyone with flu symptoms should go home and isolate. Everyone should abstain as much as possible from crowded meeting places. Elementary schools were closed, pubs were out of bounds. Two days later secondary and Sunday Schools and the Girls’ and Boys’ Grammar Schools closed. On November 6 the Bradford Telegraph reported on the workload of doctors: “...the patients of a medical gentleman in Great Horton were so numerous that his surgery could not accommodate them, a queue of considerable dimensions formed outside and extended along the street for some 20 yards”.

Similar situations were recorded in the biography of Dr Eurich, one of Bradford’s most eminent doctors. He reported that a colleague encountered five dead victims in one house, and at a house where a small child was heard crying, a neighbour broke in and found both parents dead.

Repeated warnings, particularly about avoiding crowds, ran in the papers. But few heeded the MoH’s words when Armistice Day arrived. The whole country went out on the streets to celebrate, and Bradford was no different. The result was evident in the massive increase in deaths from influenza in the weeks immediately following November 11. In the country as a whole, influenza deaths reached 19,000. In Bradford 125 died.

Bradford Infirmary closed its doors to new patients, as a large proportion of nursing staff caught influenza. Patients were sent home, operations suspended, visitors forbidden. And Bradford’s cemetery staff worked a seven-day week.

At last, on December 6, the epidemic showed signs of abating. Patients in the Infirmary were sent gifts by philanthropists, the Workhouse inmates had Christmas dinner and a concert, picture houses were opened and football matches drew crowds. The Bradford Telegraph contributed to the festive season with a column of jokes about the flu epidemic. But the bereaved families of the 597 victims who’d died from this second wave were probably not amused, nor in a mood for celebrating Christmas. The third epidemic, which came early February, was less virulent but still highly dangerous. Next week we look at how this third outbreak struck Bradford.